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General NPI Number Information
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NPI Number | 1760164487
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Entity Type | Organization
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Legal Business Name | ADAPT PERFORMANCE PHYSIO, LLC
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Dates
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Enumeration Date | 08/02/2023
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Last Update Date | 08/02/2023
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Provider Practice Location Address
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Address Line | 12048 TESSON FERRY RD
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City | SAINT LOUIS
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State | MO
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Zip | 63128-1727
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Country | US
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Telephone | 314-849-4455
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Fax |
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Provider Business Mailing Address
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Address Line | 1044 SCHUMACHER RD
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City | FENTON
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State | MO
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Zip | 63026-5192
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Country | US
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Telephone | 618-210-7735
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ZOE MUNIE
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Credential | DPT
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Telephone | 618-210-7735
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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